Wise ones,

I recently saw a client that has a 3+ week old male and a 26 month old
female.  She had difficulty nursing 1st babe and discontinued trying at 2.5
months. She definitely planned to nurse this baby.  She did not contact me
prior to delivery.  Uneventful pregnancy & delivery; she had an epidural X 2
hrs and delivered vaginally over an intact perineum. 

Mom had decreased nursing to one time per 24 hours due to pain!  She began
giving ABM via bottle @ day 5; amazingly baby went to breast and nursed
eagerly transferring 32 ml from one breast.  His latch was beautiful and
there was NO evidence of TT. We visited while babe was nursing and mom never
c/o'd of pain, winced or gave any other sign of distress.  Nipples were
without evidence of trauma altho' she said that was b/c she had only been
nursing one time/day. She had tried APNO but stated she was afraid to use it
due to steroid, she also stated that Soothies (hydrogel patches) did not
work.  Every thing I offered was something tried and failed.  I strongly
encouraged mom to change positions to decrease irritation, express MM and
allow to air dry after nursing, use APNO and then try hydrogel patches.  She
had decided against Soothies b/c they were "disposable & single use."  I
assured her they could be reused (place on plastic card and in zip lock bag
when not in use) as long as they were not dry.

I f/u'd per phone the day after the visit; she had NOT followed my
suggestions but stated that I "encouraged" her and that she would again try.
Do you all have any suggestions? I am experienced but at a loss with this
mom.

Royce

What you permit, you promote	
	
Royce Anderson
RN, IBCLC, RLC, CD (DONA) 	
The Focal Point
7608 Brookside Drive
Oklahoma City, OK 73132-5641 	
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